Confused about CBT

[chickentender]

So, I'm trying CBT for the first time and I'm a bit confused. My sessions are remote. I had to fill out an intake, which was much less personal than any other intake I've had and that's really how I'm finding the therapy to be also. I didn't realize when I signed up that it's supposed to be like 10-ish lessons and then you're supposed to be good to go. I have complex trauma (PTSD), health anxiety, GAD, social anxiety and some low level depression at times.

I've heard many times that this type of therapy is good for people with PTSD, anxiety, health anxiety etc. I've only ever had talk therapy previously and I'd been doing that pretty continuously for almost 15 years. I'm finding aspects of CBT helpful in ways that talk therapy wasn't, but what I'm not finding helpful is that I come away from my sessions feeling like I've over shared. I don't know if I'm just not getting that I shouldn't be mentioning the past that comes up and causes me flares of the issues I struggle with or if I'm just supposed to be like "I had anxiety this week" and then we talk about exercises.

But, I feel like if my therapist doesn't know me much, this is kind of a one size fits all approach? Is that what it's supposed to be? I get that it's supposed to be strategies to cope with how we react to our feelings, but, what about the stuff I need to actually speak to a therapist about that's weighing on me? Is that out of place in a CBT setting? Should I just keep it to myself in a journal or something? I just tend to come out of my sessions feeling like I should have shut up more. I can't tell if it's my social anxiety or me not grasping what I'm supposed to be saying in CBT or what.

After 2 sessions I had to fill out a thing that was about my relationship with the therapist I'm seeing and I was thinking how do I even answer this? I've literally had two 45 minute sessions and we're basically strangers.

Any thoughts?

 

[bin_tenn]

I've personally always understood CBT to be something that happens during a general therapy session. That CBT is a set of tools that can be taught and should supplement the standard ("talk") therapy. Is my understanding incorrect? Or is this also what you're confused about?

When I saw a therapist a handful of times, it was very productive. We talked plenty, but we also took time in each session to discuss various techniques that are common in CBT. More specifically, my therapist would choose CBT-like techniques to practice based on whatever we talked about during the session. So it changed each time.

I've not heard of CBT as a strict subset of therapy that is taught in some defined number of sessions.

 

[chickentender]

I've personally always understood CBT to be something that happens during a general therapy session. That CBT is a set of tools that can be taught and should supplement the standard ("talk") therapy. Is my understanding incorrect? Or is this also what you're confused about?

When I saw a therapist a handful of times, it was very productive. We talked plenty, but we also took time in each session to discuss various techniques that are common in CBT. More specifically, my therapist would choose CBT-like techniques to practice based on whatever we talked about during the session. So it changed each time.

I've not heard of CBT as a strict subset of therapy that is taught in some defined number of sessions.

Yes, what you're describing is also what I expected it would be. Talk therapy combined with cbt exercises to do. It seems to focus just on what I am feeling in the present and if I go into backstory about my life, I get the impression that I'm....wasting my therapist's time almost? I don't know if this is my therapist in particular or me not understanding what I'm supposed to talk and not talk about.

 

[Jonathan123]

Yes, what you're describing is also what I expected it would be. Talk therapy combined with cbt exercises to do. It seems to focus just on what I am feeling in the present and if I go into backstory about my life, I get the impression that I'm....wasting my therapist's time almost? I don't know if this is my therapist in particular or me not understanding what I'm supposed to talk and not talk about.

There should never be anything you should not talk about in a counselling session. As an ex counsellor I hardly ever used CBT. It's another of those'mind body' therapies that leaves out that essential element in mankind, that other you. That indefinable something in you that knows all the answers. CBT techniques can be used in general counselling, like asking why we think something will happen, or how we catastrophise. Are you seeing your therapist face to face or on line? You are confused, and that is not what counselling is supposed to do.
The back story of your life is what made you, and may well be what is causing your anxiety now. It is VERY important that this subject should be brought up and examined. When you begin any therapy you enter upon a journey, and it is mostly a journey into the unknown. Repressed emotions need to be brought to light and seen for what they are. For my taste CBT is too superficial. Now like all therapies many do get some relief from it, so we must be careful not to throw the baby out with the bathwater! Many counsellors adhere to a certain line of theory, and it's case of horses for courses. I practised mostly the theories of Carl Jung, but any therapy has to be tailored to the specific patient. There is no 'fit all' therapy as in CBT. I do agree that the present is important and needs to be dealt with, but so do any repressed emotions.

 

[chickentender]

There should never be anything you should not talk about in a counselling session. As an ex counsellor I hardly ever used CBT. It's another of those'mind body' therapies that leaves out that essential element in mankind, that other you. That indefinable something in you that knows all the answers. CBT techniques can be used in general counselling, like asking why we think something will happen, or how we catastrophise. Are you seeing your therapist face to face or on line? You are confused, and that is not what counselling is supposed to do.
The back story of your life is what made you, and may well be what is causing your anxiety now. It is VERY important that this subject should be brought up and examined. When you begin any therapy you enter upon a journey, and it is mostly a journey into the unknown. Repressed emotions need to be brought to light and seen for what they are. For my taste CBT is too superficial. Now like all therapies many do get some relief from it, so we must be careful not to throw the baby out with the bathwater! Many counsellors adhere to a certain line of theory, and it's case of horses for courses. I practised mostly the theories of Carl Jung, but any therapy has to be tailored to the specific patient. There is no 'fit all' therapy as in CBT. I do agree that the present is important and needs to be dealt with, but so do any repressed emotions.

I also am left with the feeling that it's superficial. Though, some of the things I'm learning are helpful. It's remote therapy. This therapist said that she thought she could help me in ten sessions. And while I am doing well overall compared to how I had been doing in the past, even before starting this therapy (I started again because my stress is high lately, so I needed some more support than usual), I feel like I need a sort of support from therapy in regard to processing my traumas mostly as well. I'm at the point of rebuilding myself and my life and I feel like 10 sessions where I feel awkward when I mention my trauma isn't what I need. This is what is offered through job benefits at the moment though and is free for 10 sessions when using this therapy service. I'm learning ways to deal with situations that come up in the moment, which will contribute to feeling better overall in the long run, but I feel like there are things I need to address that are getting skipped over because they don't fit into what seems like some kind of predetermined framework of how this therapy is supposed to go. Then afterward, I feel kind of bad because I feel like maybe my life is too messy for this therapist and maybe I'm a downer because I'm getting the impression that my trauma when I've brought any of it up is kind of...inappropriate somehow or too dark or heavy to discuss in this setting? I've never felt that before from therapy!!

 

[Jonathan123]

I also am left with the feeling that it's superficial. Though, some of the things I'm learning are helpful. It's remote therapy. This therapist said that she thought she could help me in ten sessions. And while I am doing well overall compared to how I had been doing in the past, even before starting this therapy (I started again because my stress is high lately, so I needed some more support than usual), I feel like I need a sort of support from therapy in regard to processing my traumas mostly as well. I'm at the point of rebuilding myself and my life and I feel like 10 sessions where I feel awkward when I mention my trauma isn't what I need. This is what is offered through job benefits at the moment though and is free for 10 sessions when using this therapy service. I'm learning ways to deal with situations that come up in the moment, which will contribute to feeling better overall in the long run, but I feel like there are things I need to address that are getting skipped over because they don't fit into what seems like some kind of predetermined framework of how this therapy is supposed to go. Then afterward, I feel kind of bad because I feel like maybe my life is too messy for this therapist and maybe I'm a downer because I'm getting the impression that my trauma when I've brought any of it up is kind of...inappropriate somehow or too dark or heavy to discuss in this setting? I've never felt that before from therapy!!

As I said before, CBT can help some and has helped many I am sure. Dealing with the immediate problem is helpful, and CBT may be good for that, but underlying causes are not looked at. There is always a cause for anxiety, and it is so often deep in the unconscious that the problem lies. How long does therapy take? How long is a piece of string? Many people seem to recover fairly quickly. For others it may take years. It does depend on how we approach anxiety and how persistent we are in getting relief. It can be a long hard road full of pitfalls, but recovery is always possible if we never give up hope.

 

[chickentender]

As I said before, CBT can help some and has helped many I am sure. Dealing with the immediate problem is helpful, and CBT may be good for that, but underlying causes are not looked at. There is always a cause for anxiety, and it is so often deep in the unconscious that the problem lies. How long does therapy take? How long is a piece of string? Many people seem to recover fairly quickly. For others it may take years. It does depend on how we approach anxiety and how persistent we are in getting relief. It can be a long hard road full of pitfalls, but recovery is always possible if we never give up hope.

Thank you for your replies, it has helped me to understand what to expect more. I've been in therapy for 14 years and I feel I am in the final stretch of really making peace and coming to terms with my trauma. I think the things I'm learning in CBT will help also. I guess my impression was correct that it doesn't go too deep into the stuff underlying the issues. At any rate, I will continue and take whatever is helpful over the course of the 10 sessions and then see where I want to go from there I think!

 

[Sweet T]

Have you ever looked into EMDR? It’s a common therapy for complex PTSD. Can be used in combination with CBT as well.

 

[Fraser]

There should never be anything you should not talk about in a counselling session. As an ex counsellor I hardly ever used CBT. It's another of those'mind body' therapies that leaves out that essential element in mankind, that other you. That indefinable something in you that knows all the answers. CBT techniques can be used in general counselling, like asking why we think something will happen, or how we catastrophise. Are you seeing your therapist face to face or on line? You are confused, and that is not what counselling is supposed to do.
The back story of your life is what made you, and may well be what is causing your anxiety now. It is VERY important that this subject should be brought up and examined. When you begin any therapy you enter upon a journey, and it is mostly a journey into the unknown. Repressed emotions need to be brought to light and seen for what they are. For my taste CBT is too superficial. Now like all therapies many do get some relief from it, so we must be careful not to throw the baby out with the bathwater! Many counsellors adhere to a certain line of theory, and it's case of horses for courses. I practised mostly the theories of Carl Jung, but any therapy has to be tailored to the specific patient. There is no 'fit all' therapy as in CBT. I do agree that the present is important and needs to be dealt with, but so do any repressed emotions.

CBT has an excellent track record with health anxiety, whereas Jungian psychoanalysis does not.

Thank you for your replies, it has helped me to understand what to expect more. I've been in therapy for 14 years and I feel I am in the final stretch of really making peace and coming to terms with my trauma. I think the things I'm learning in CBT will help also. I guess my impression was correct that it doesn't go too deep into the stuff underlying the issues. At any rate, I will continue and take whatever is helpful over the course of the 10 sessions and then see where I want to go from there I think!

You need clarification from your therapist if this isn't clear. CBT examines your harmful tendencies, such as catastrophizing, gets you to recognize them, and then provides alternatives that take time and effort to implement. Some background info about why you think what you think is important, but ultimately it is more results oriented. "When you think X, consciously consider Y." In time, you will start to think Y more than X. CBT is popular because it tends to work.

 

[Jonathan123]

I didn't say I practised Jungian psychoanalysis. That is for psychiatrists. Jungian theory goes way beyond the normal approach to any mental disorder. It brings in that other element of mankind, the side that most reject because it smacks of religion, which it is not.
In spite of the material aspect of mankind, which is so very prevalent these days, there is always, deep down, that other element that although unrecognised is always there and it is what keeps us afloat in difficult times. Airy fairy? Maybe, but the recognition of that part of us can help a lot. When you say Jungian psychoanalysis does not help how do you know? Have you studied Jungian theory? During Jung's lifetime people came from all over the world to meet him and obtain help. He must have been doing something right!
But, like religion, it would not be used on a person who was not amenable to such treatment. I did say that therapy should be tailored to the individual. I would certainly discuss religion with a religious person, but only if it was part of their lives, not ever to try and covert someone to my beliefs. That is not what good counselling is about.

 

[Fraser]

Maybe, but the recognition of that part of us can help a lot. When you say Jungian psychoanalysis does not help how do you know?

Metanalysis of peer reviewed research on the effects of classical (Freudian/Jungian) talk therapy on health anxiety disorder.

Have you studied Jungian theory?

Yes.

During Jung's lifetime people came from all over the world to meet him and obtain help. He must have been doing something right!

During Galen's time, lots of people came to him to get their yellow bile reduced. He must have been right!